by A 91-year-old man has made history by becoming the first patient in England to receive an artificial cornea.
Cecil Farley had to wait a year for vision surgery after a failed human cornea transplant, but his surgeon allowed him to skip the queue by using an artificial head.
Doctors hope that the new artificial corneas will one day reduce the need for human cornea donations.
Thomas Poole, consultant ophthalmologist at Frimley Health Foundation Trust, told the PA news agency that “the use of artificial corneas is a great advance for patient care.
The new product replaces the inner part of the cornea.
It has been compared to a contact lens surgically attached to the eye with a single stitch and replaced with a gas bubble.
Mr Farley, known to his friends as John, said the transplant operation had enabled him to continue to see his 83-year-old wife Elizabeth.
He had no vision in his right eye but his vision has slowly improved since the procedure, which took place in February.
Mr Farley, from Chobham in Surrey, had had problems with his eye for around 15 years.
Doctors from Frimley offered the procedure, which is a type of corneal implant called endothelial keratoplasty and involves removing the abnormal inner lining of the cornea and replacing it with an artificial cornea, rather than a donated human cornea.
“I can still see my wife after 63 years of marriage, we can carry on as normal and live as fully as we can,” Mr Farley told PA.
“It makes your life fuller when your eyes work properly – you don’t realize how weak it is until it happens to you.”
The pensioner, who used to be a floor company, said he wants to do practical tasks such as repairing a watch, once his sight is fully restored, but for now he is happy to “be having fun”.
“It made a huge difference to my sight. It was very blurry and I couldn’t distinguish a face. Now I can see better with it, the brighter the light the better. It’s coming along slowly – they said it could take up to a year,” Mr Farley said.
The cornea is the clear outer layer at the front of the eyeball.
When the cornea is damaged as a result of injury or disease, it can become transparent or change its shape.
This can prevent light from reaching the retina at the back of the eye and causes the image transmitted to the brain to be distorted or blurred.
Corneal transplants can be performed to improve vision, relieve pain and treat infection or serious damage.
Corneal transplants usually come from deceased donors.
Mr Poole and his colleague, Hanbin Lee, have successfully given artificial corneas to four patients over the past two months and initial results have shown an improvement in vision.
“It’s a great advance for patient care, and it’s going to be a great opportunity for some patients who can’t wait too long or have other co-morbidities in the eye,” said Mr Poole.
“We now have a very long waiting list for human corneas, which we have been using very successfully for many years. The problem is if you have patients whose eyes are deteriorating, you can’t get a human cornea for over a year.
“Staying on a waiting list with a sore eye has its risks; there are risks if nothing is done as well, such as getting an infection.
“One of the beauties of (the artificial cornea) is that it’s not human tissue so the body doesn’t try to reject it.
“Looking forward to the future, I think this could lead to the replacement of human corneas for certain types of corneal graft patients. In maybe 10 or 20 years – maybe this will become the norm where we don’t need a human cornea, and we can take one out of the box.”
Mr Poole said: “I’ve just booked three people for this. All three have failed in the past, all three are looking at a year long waiting list. We can get it straight from the shelf. I can do it in the first few months instead of waiting for a year.
“The three patients I listed today are a special case – they won’t need human corneas now so it will take some pressure off the waiting lists.”
Speaking about Mr Farley’s case, Mr Poole said: “A corneal graft failed and his cornea – which is the clear window to the front of the eye – was cloudy and flooded.
“He’s had a lot of surgeries before and my concern was that we could use a human cornea for him again, but that has a high risk of failure … it was kind of the last hope. .
“John had this artificial cornea implanted in February and clinically we can already see that his cornea is much less swollen than it was, that it is improving its shape, and improving clarity. Week after week he’s been saying he’s getting a little bit better each time.”
Mr Poole added: “I had a very honest discussion with him before and I said ‘Look, your graft has failed, you’re back on the waiting list. Because your other eye can see well, you are not a high priority on the waiting list and could be waiting another year’.
“He’s in his 90s now and he said ‘I can’t wait that long. Is there anything else?’ And so this came to mind, I had just read a publication about very good reports from this artificial birth and that really made me think, maybe we could use this for John.”
NHS England’s national medical director, Professor Sir Stephen Powis, said: “The use of artificial corneal transplantation is an exciting and innovative step forward in eye care, which could benefit many patients who need treatment to improve or restore vision.
“It could provide an additional treatment option for those waiting for a donor transplant, and it’s heartening to hear of patients like Cecil who are already benefiting from its use.”
In 2022/23, according to the latest figures available, around 4,719 corneas were supplied to the NHS Eye Blood and Transplant Banks and 3,529 transplants were performed.
In the past, some potential organ donors have said they were willing to donate organs including hearts, livers and kidneys but chose not to donate their kidneys.
Kyle Bennett, assistant director of tissue and eye services at NHS Blood and Transplant, said: “We understand that people often attach more emotion and symbolism to the eyes than other parts of the body so they can be reluctant to agree. with cornea donation.
“However, agreeing to this type of donation, even when solid organ donation is not possible, can be a light after darkness for thousands of people who need a cornea transplant.
“One donor can help up to 10 people restore or improve their vision and allow them to see their friends and family properly again.
“We are very grateful to all those who agreed to donate their corneas posthumously and restored or improved the sight of 3,259 people last year through cornea transplants.”
The ophthalmology medical device company EyeYon Medical created the new artificial cornea, called EndoArt.
There are only 200 implants in the world so far, including Mr. Farley.
“EndoArt is the first artificial endothelial layer, a promising treatment for select eyes with chronic corneal edema,” said the company’s chief commercial officer, Charles Holmes.
“EndoArt represents a new hope for patients suffering from chronic corneal edema as an alternative to human tissue.”
